The poorer, the fatter: Obesity is not randomly distributed across the U.S. It is linked to demographics, community characteristics, income inequality, and race, 500-city analysis shows.

According to data published by the National Institute of Diabetes and Digestive and Kidney Diseases, more than two in three adults in the United States are considered to be overweight or obese. However, this problem is not randomly distributed across the country. In fact, according to a new University of Arkansas study, obesity is particularly prevalent in certain areas; areas with socio-economic factors that create an “ecology of disadvantage,” as the researchers put it. This includes various social and demographic components.

Titled “Obesity and place: Chronic disease in the 500 largest U.S. cities” and authored by Kevin M. Fitzpatrick, Xuan Shi, Don Willis, Jill Niemeier, the study was recently published in the peer-reviewed journal Obesity Research & Clinical Practice.

Lead author Kevin Fitzpatrick is a University Professor of sociology at the University of Arkansas. Xuan Shi is currently an assistant professor in the Department of Geosciences at the University of Arkansas, Jill Niemeier is a University of Arkansas sociology graduate student, and Don Wills is a doctoral student at the University of Missouri.

The objective of the study was to confirm what previous research had shown: the correlation between place and health, as it pertains to obesity.

The authors wrote the following.

“Extant research clearly points to a correlation between place and health, specifically as it pertains to chronic diseases like obesity. The present study examines this relationship among a diverse set of compositional place indicators and obesity rates across census tracts in the 500 largest cities in the United States.”

The researchers used data from the Robert Wood Johnson Foundation. The RWJF is the largest health-focused philanthropy in the United States. Fitzpatrick and his colleagues used data compiled from the Robert Wood Johnson Foundation 500 Cities project and the Census’ American Community Survey. The 500 Cities project, published in 2017, provides data for 500 of the largest American cities, with the goal of identifying emerging health problems.

Among other things, the 500 city data is meant to aid public health officials in painting a complete picture of health in their region. Furthermore, it is meant to help policymakers and community leaders identify public health issues and take action to tackle them. University of Arkansas researchers used this data to conduct their study.

“What this data provided was the ability to map chronic disease as it relates to where people live,” lead author Kevin M. Fitzpatrick told the University of Arkansas News, stressing the importance of the study. “These two big data groups – chronic health disease data and structural place data – have not been combined in this way at this level until now.”

Simply put, place plays a significant role in an individual’s overall health and well-being.

“‘What’s your zip code?’ is fast becoming one of the most important things your doctor could ask you, not ‘How are you feeling today?'” Fitzpatrick said.

The researchers concluded, “Place matters. The continuing burden of zip code in the United States for disenfranchised populations will likely continue to force policymakers to examine the role that place-based prevention and place-focused medical care plays in the future health and well-being of U.S. residents.”

The highest levels of obesity were found along the southern coast of Alabama, Louisiana, and Texas, as well as in eastern coastal regions of Massachusetts, New Jersey, and New York. Likewise, high levels of obesity were found in the Great Lakes region. California was found to have the highest concentration of normal-weight populations.